Abstract
To identify the factors that influence the necessity of tracheostomy in patients with deep neck abscess who underwent an abscess incision, we performed physical examination, imaging investigations, etc. for 36 patients at our hospital. Tracheostomy was performed in 20 of the 36 patients. On preoperative contrast-enhanced computed tomography (CT) images, cases with abscess formation in any of the parapharyngeal space, visceral space, carotid space, or posterior pharyngeal space (referred to as the “specific 4 spaces”) were compared with those without abscess formation. There was a high rate of statistically significant laryngeal edema (p<0.01) and tracheostomy (p<0.01). Furthermore, with regard to the “specific 4 spaces,” a significantly higher proportion of patients with abscess formation in 3 or more spaces underwent tracheostomy compared to those with abscess formation in fewer than 3 spaces (p<0.01). On preoperative contrast-enhanced CT images, abscess formation in patients with deep neck abscess was noted in the visceral space, carotid space, posterior pharyngeal space that extends below the hyoid bone and is adjacent to the larynx, as well as in the parapharyngeal space, which is an important starting point for these spaces. Accurate assessment of the presence or absence of abscess formation in the “specific 4 spaces” was considered to be a measure of appropriate airway intervention.
